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The Authors' reply: We thank Drs Armoiry and Connock for their thoughtful comments and questions1 regarding our report on the cost-effectiveness of transcatheter edge-to-edge mitral valve repair (TEER) for patients with heart failure and severe secondary mitral regurgitation (MR) from the perspective of the UK National Health Service.2 They raise two important questions regarding our analysis: the first regarding alternative approaches to life expectancy projection and the second regarding the disparity between the results of the percutaneous repair with the MitraClip device for severe functional/secondary mitral regurgitation (MITRA-FR) and cardiovascular outcomes assessment of the MitraClip percutaneous therapy for heart failure patients with functional mitral regurgitation (COAPT) trials.
The reason why we did not incorporate 3-year follow-up data from the COAPT trial in our projections is straightforward. As described in our paper, after completion of 2-year follow-up, patients randomised to the control group (guideline-directed medical …
Contributors DJC: Drafted the letter. EAM: Revised the letter for content. GWS: Revised the letter for content. JGFC: Revised the letter for content. All authors have approved the current version of the response letter.
Funding This study was funded by Abbott Laboratories.
Competing interests DJC has received research grant support and consulting income from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic. EM has nothing to disclose. GWS has received speaker honoraria from Medtronic, Pulnovo, Infraredx; consultant fees from Valfix, TherOx, Robocath, HeartFlow, Ablative Solutions, Vectorious, Miracor, Neovasc, Abiomed, Ancora, Elucid Bio, Occlutech, CorFlow, Apollo Therapeutics, Impulse Dynamics, Vascular Dynamics, Shockwave, V-Wave, Cardiomech, Gore, Amgen; equity/options from Ancora, Cagent, Applied Therapeutics, Biostar family of funds, SpectraWave, Orchestra Biomed, Aria, Cardiac Success, Valfix, Xenter. GWS's employer, Mount Sinai Hospital, receives research support from Abbott, Bioventrix, Cardiovascular Systems Inc, Phillips, Biosense-Webster, Shockwave, Vascular Dynamics and V-wave. JGFC has received research grants from Amgen, Bayer, Bristol Myers Squibb, Vifor, Pharacosmos, Vyokinetics, Johnson and Johnson, MyoKardia, Stealth Biopharmaceuticals and Viscardia; honoraria from Abbott, Bayer, Bristol Myers Squibb, Novartis, Medtronic, Idorsia, Vifor, Pharmacosmos, Cytokinetics, Servier, Boehringer-Ingelheim, AstraZeneca, Innolife, Torrent, Johnson & Johnson, MyoKardia, Respicardia, Stealth Biopharmaceuticals and Viscardia.
Provenance and peer review Commissioned; internally peer reviewed.
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